On the heels of a capitol briefing
from WHA urging lawmakers to take action to reduce barriers that restrict access to telehealth, a bipartisan group of four state lawmakers released legislation to modernize Medicaid’s telehealth policies. The WHA-supported legislation is the result of recommendations from WHA’s Telehealth Work Group, which included participation from more than 36 hospital and health system members across Wisconsin.
The Work Group spent the past three years reviewing access to telehealth, as well as regulatory barriers to increasing access for Wisconsin’s Medicaid population. It recommended four areas where legislation could help improve access to health care via telehealth:
- Require all current Medicaid services to also be covered under telehealth as long as they can be offered in a manner functionally equivalent in quality to an in-person visit.
- Catch up to Medicare by covering the 75 telehealth-related codes Medicare currently covers that Medicaid does not, while updating Medicaid’s covered telehealth services to keep pace with Medicare.
- Allow Medicaid to cover in-home or community services via telehealth – something Wisconsin is one of only six states to not allow.
- Repeal the additional telehealth certification providers are required to obtain before offering behavioral health services via telehealth. WHA’s Work Group identified this telehealth certification as a barrier to expanding behavioral health treatment options. Providers would still need to obtain their licensure from the Wisconsin Department of Safety and Professional Services and their Medicaid certification as they currently do for other services.
The bipartisan legislation introduced by Representatives Amy Loudenbeck (R - Clinton) and Deb Kolste (D - Janesville), and Senators Dale Kooyenga (R - Brookfield) and Janet Bewley (D - Mason), incorporates these four recommendations.
“WHA supports this legislation because removing barriers to telehealth in the Medicaid program improves health care access and outcomes without increasing program costs,” said Eric Borgerding, WHA President and CEO.
Recent evidence shows that any increases in health care utilization are offset by lower costs resulting from fewer inpatient admissions and ER visits, coupled with the ability to treat conditions sooner and more effectively before they become more complex conditions that are harder and more expensive to treat. For example, analysis from the state employee health insurance program and a 2019 analysis by the federal Centers for Medicare & Medicaid Services concluded that covering benefits through telehealth would result in no net increased costs to the state employee health insurance or Medicare programs, respectively, because telehealth coverage reduces downstream costs associated with a lack of access to care.
WHA encourages members to contact their legislators
and ask they sign onto LRB-2755 prior to the August 21 deadline. More information can be found in WHA’s Advocacy Day handout on telehealth
Contact WHA’s Director of Federal and State Relations Jon Hoelter